New CMS data shows plenty of fight in HME providers

Thursday, October 14, 2010

YARMOUTH, Maine - Despite all the audits, regulatory hurdles and other challenges that HME providers have had to deal with over the past year, new data from CMS shows most providers are holding their own--or at least hanging on for dear life.

As of Sept. 1, 2010, there were 100,523 active Medicare DMEPOS supplier numbers, according to data HME News received from CMS last week. That's up from 97,164 on Jan. 1, 2010.

Not only are HME providers not buckling under onerous market forces, but new providers continue to enter the market, say officials at HQAA and The Compliance Group, two industry accreditation organizations.

The reason's simple, they say: Despite the threat of competitive bidding, the market for home medical equipment is big and getting bigger.

"We get calls on a weekly basis," said Sandra Canally, president of The Compliance Team. "Some are experienced people who have worked in the industry and now want to start their own business. Then there are folks that somewhere along the way have been told that you can make money in DME."

It's important to note that only about one-third of the active supplier numbers belong to HME providers. Roughly half belong to pharmacies and the rest to chiropractors, physicians and other healthcare professionals.

Besides new HME providers entering the market, another factor appears to be boosting the number of active supplier numbers, says Mary Nicholas, executive director of HQAA. She's seeing more physicians becoming accredited so that they can get a supplier number and bill Medicare for DME items. These are not bread-and-butter DME products like power wheelchairs, but splints and other small items that physicians routinely give to patients.

"Some of the physicians have just begun to realize, 'Oh, my gosh. I can bill for those things? I thought they were a part of my overall fee?'" Nicholas said. "If a physician has 300 appointments where he's giving a patient a $12 item, that can add up."

Of course, while audits and other challenges have not yet significantly reduced the number of HME providers, all bets are off when it comes to competitive bidding.

"That is my biggest concern," Canally said. "What will the numbers be after competitive bidding?"

Here's some of the CMS data:

The number of active DMEPOS suppliers as of Jan. 1, 2010:

Jurisdiction A: 20,368

Jurisdiction B: 19,907

Jurisdiction C: 35,754

Jurisdiction D: 21,135

Total: 97,164

The number of active DMEPOS suppliers as of as of Sept. 1, 2010

Jurisdiction A: 21,024

Jurisdiction B: 20,576

Jurisdiction C: 36,793

Jurisdiction D: 22,130

Total: 100,523